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PROPRIOCEPTIVENEUROMUSCULARFACILITATIONNTHE KNEE

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KNEE ANATOMY

Knee joint

consists of:

LCL, MCL, ACL, PCL

Meniscus

Patellar tendon

Patella2

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PATELLOFEMORAL PAIN

Most common diagnosis with patients whohave knee pain (esp. for runners and in sports

medicine).

Anterior knee pain or runners knee which

contains the retinaculum and patella. Chondromalaciais secondary to this

syndrome.

Patient will complain of:

Aching knee joint, particularly on or around

patella Clicking/cracking

Pain while ascending or descending stairs orhills

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RISK FACTORS

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Trauma/Previous Injury or Surgery

Mal-alignment

Hypermobility of patella

Muscle weakness Poor flexibility

Overuse

Abnormal tracking of

patella

Tight hamstrings, IT band,

retinaculum, etc.

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PATELLOFEMORAL PAIN

SYNDROMETREATMENTS

RICE

VMO strengthening

Stretching

Release the tight lateral structures.

Strengthening the hips, quads, hams,

othersupporting muscles to help support theQ

angle.

Bracing

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PROPRIOCEPTIVE NEUROMUSCULARFACILITATION (PNF)

PNF is defined as functionally based diagonal pattern

movements with neuromuscular control and functionaltechniques.

Used to exercise and rehabilitate by using ADL

patterns.

This is because we utilize multiple muscles at thesame time while performing ADLs

10 different components in PNF

Manual contacts, body positioning/mechanics,stretch, manual resistance, irradiation, jointfacilitation, timing of movement, patterns ofmovement, visual cues, verbal input.

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PNF

Utilized to: Increase stability and strength

Increase coordination

Increase mobility

Extremity Patterns:

Diagonal 1 & Diagonal 2

-Flexion or Extension

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PNF Techniques for PFPS

The goal of PNF techniques is to promote functional

movement through facilitation, inhibition,strengthening, or relaxation of muscle groups.

Strengthening Techniques

Rhythmic Initiation

Rhythmic Stabilization

Repeated Contraction

Slow Reversal

Slow Reversal Hold

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PNF Techniques for PFPS

Rhythmic Initiation:

Passive motion active assistive motion activemotion

Rhythmic Stabilization:

Isometric contraction of agonist Isometriccontraction of antagonist

Repeated Contraction

Isotonic contraction against a max. resistance inconcentric and eccentric motions

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PNF Techniques for PFPS

Slow Reversal

Isotonic contraction of agonist Isotonic contraction ofantagonist

Slow Reversal-Hold

Isotonic contraction of agonist isometric contraction

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BENEFITS

PNF facilitates multiple muscles in the body, which

leads to strengthening the lower extremities.

The muscles in the leg will then begin to align

everything in the proper place, esp. the patella.Also stretches muscles and tendons that may be too

tight.

PNF helps with PFPS by utilizing every issue needing

to be treated. (ie. Tight IT band, hamstrings, or weak

VMO)13

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